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Why Vitamin D?
Optimize nutrient levels prior to surgery to maximize wound healing.
The DentaMedica® Recovery Support Program aims to restore vitamin and antioxidant levels in patients prior to dental procedures to address the possibility of failure that may occur as a result of vitamin deficiencies.
| STATUS | SERUM 25 OH | Vitamin D Concentration |
|---|---|---|
Severe Deficiency | <10 ng/ml | <25 nmol/liter |
Deficiency | <20 ng/ml | <50 nmol/l |
Insufficiency | 21-29 ng/ml | 21-29 ng/ml |
Sufficiency | 30-100 ng/ml | 75-250 nmol/l |
Optimal | 30-60 ng/ml | 75-150 nmol/l |
Toxic | >150 ng/ml | >375 nmol/l |
Pre-surgery | 40-60 ng/ml | 100-150 nml/l |
Vitamin D deficiency is a worldwide public health problem that spans across all age groups from children to adults. Naturally, as we age, our ability to absorb vitamin D is also decreased. The major source of vitamin D is directly from sunlight exposure with very few foods that naturally contain sufficient doses. Unfortunately, direct sunlight has tremendously decreased in modern society with the increased number of desk-related jobs. Epidemiological studies have now shown that roughly 70% of society is deficient.1
Vitamin D deficiency is most known for its association in osteoporotic and menopausal ladies. Few realize however its drastic and substantial role in various other diseases. These include depression, dementia, Alzheimer’s disease, asthma, cancer, cardiovascular disease, diabetes among others. Vitamin D is essential for gastrointestinal calcium absorption, mineralization of osteoid tissue and maintenance of serum ionized calcium level it is also important for other physiological functions, such as muscle strength, neuromuscular coordination, and hormone release 1. Vitamin D deficiency is associated with up to a 300% increase in dental implant failure rate while also increasing dental-related complications. Optimizing levels prior to surgery therefore becomes fundamental for maximized wound healing.
Serum 25-hydroxy vitamin D (25-OHD) is the reliable marker of vitamin D status and a level below 20 ng/ml defines deficiency. Optimal levels above 30 ng/ml is required to maximize the bone health and non—skeleton benefits of vitamin D. For individuals undergoing any type of dental related procedures, levels between 40-60 ng/ml are generally recommended since it is known that following a period of stress (simply a dental surgical intervention), levels may decrease substantially.
Causes of Vitamin D Deficiency
The major source of vitamin D is exposure to sunlight. More than 90% of the vitamin D requirement is obtained from casual exposure to sunlight. Patients undergoing dental therapies are generally encouraged they spend more time in the sun prior to surgery.
Unfortunately, foods do not contain sufficient levels. Examples are Cod liver oil (400-1,000 IU/teaspoon), fresh caught salmon (600-1,000 IU/3.5 oz vitamin D3), tuna (236 IU/3.5 oz vitamin D3), egg yolk (20 IU/yolk vitamin D3 or D2), and fortified milk, cheese or yogurt (100 IU/3 oz, usually vitamin D3). These are low levels considering deficiency should be treated with 4000-6000 IU/day for an 8 week period to restore levels to sufficient values
DentaMedica® boosts bone-related support to optimal levels prior to dental surgery
DentaMedica® boosts bone-related support to optimal levels prior to dental surgery
Owing to the impact of vitamin D deficiency-related complications and failures in dentistry, one key component of the DentaMedica® support Program is that patients adequately reach optimal levels prior to dental surgery. Bone-related support includes vitamin K, magnesium, calcium, manganese and boron. The 6-week program is designed to boost levels prior to surgery (6000 IU/day) for 4 weeks with 2 weeks of maintenance post-surgery. For those undergoing extensive surgery, for patients over 65 years of age, for diabetics, smokers, or patients with reported immune-compromised or on corticosteroids, a 12 week program is recommended (8 weeks prior to surgery and 4 weeks postsurgery).
References
- Woo YS, Kim S, Jeong JH, Jung YE, Kim MD, Bahk WM. Vitamin D Deficiency/Insufficiency among Inpatients with Depressive Symptoms. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology 2019;17:121-124.
- Wimalawansa SJ, Razzaque MS, Al-Daghri NM. Calcium and vitamin D in human health: Hype or real? The Journal of steroid biochemistry and molecular biology 2018;180:4-14.
- Akhavan A, Noroozi Z, Shafiei AA, Haghighat A, Jahanshahi GR, Mousavi SB. The effect of vitamin D supplementation on bone formation around titanium implants in diabetic rats. Dental research journal 2012;9:582-587.
- Bryce G, MacBeth N. Vitamin D deficiency as a suspected causative factor in the failure of an immediately placed dental implant: a case report. Journal of the Royal Naval Medical Service 2014;100:328-332.
- Choukroun J, Khoury G, Khoury F, et al. Two neglected biologic risk factors in bone grafting and implantology: high lowdensity lipoprotein cholesterol and low serum vitamin D. The Journal of oral implantology 2014;40:110-114.
- Fretwurst T, Grunert S, Woelber JP, Nelson K, Semper-Hogg W. Vitamin D deficiency in early implant failure: two case reports. Int J Implant Dent 2016;2:24.
- Guido Mangano F, Ghertasi Oskouei S, Paz A, Mangano N, Mangano C. Low serum vitamin D and early dental implant failure: Is there a connection? A retrospective clinical study on 1740 implants placed in 885 patients. Journal of dental research, dental clinics, dental prospects 2018;12:174-182.
- Insua A, Monje A, Wang HL, Miron RJ. Basis of bone metabolism around dental implants during osseointegration and peri-implant bone loss. Journal of biomedical materials research Part A 2017;105:2075-2089.
- Kelly J, Lin A, Wang CJ, Park S, Nishimura I. Vitamin D and bone physiology: demonstration of vitamin D deficiency in an implant osseointegration rat model. Journal of prosthodontics : official journal of the American College of Prosthodontists 2009;18:473-478.
- Liu W, Zhang S, Zhao D, et al. Vitamin D supplementation enhances the fixation of titanium implants in chronic kidney disease mice. PloS one 2014;9:e95689.
- Mangano F, Mortellaro C, Mangano N, Mangano C. Is Low Serum Vitamin D Associated with Early Dental Implant Failure? A Retrospective Evaluation on 1625 Implants Placed in 822 Patients. Mediators of inflammation 2016;2016:5319718.
- Xiong Y, Zhang Y, Guo Y, et al. 1alpha,25-Dihydroxyvitamin D3 increases implant osseointegration in diabetic mice partly through FoxO1 inactivation in osteoblasts. Biochemical and biophysical research communications 2017;494:626-633.
